Camp 220 Student Registration 2023

Camp 220 Student Summer Camp
July 17-21, 2023
$375/student- $100 non-refundable deposit
Completed 6th to 12th (as of summer 2023)

Student Info

Name

*

Student Phone

*

Gender

*

Please select one option.

Female Male

DOB

*

Completed Grade (as of summer 2023)

*

Please select one option.

6th 7th 8th 9th 10th 11th 12th

T-shirt Size (adult unisex)

*

Please select all that apply.

S M L XL 2XL 3XL

Parent/Guardian Info

Parent/Guardian Name

*

Phone

*

Email

*

This address will receive a confirmation email

Address

*

Emergency Contact Info

Emergency Contact Name

*

Emergency Contact Phone

*

Emergency Contact Email

*

COST
Total camp cost is $375/student.
$100 non-refundable deposit holds your spot.

Payment

Deposit ($100) Full Payment ($375)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Camp 220 Student Summer Camp
July 17-21, 2023
$375/student- $100 non-refundable deposit
Completed 6th to 12th (as of summer 2023)

Please Fix the Following

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